This is a brilliant concept developed by Dr. Ritchie Shoemaker. He theorizes that many different infections can produce toxins. These are toxic chemicals that can persist in the body even after the infection is gone. Normally, the body is able to excrete toxins through the liver and kidneys and eliminate them from the body. What makes these toxins unique is that only the liver excretes them. The liver excretes the toxins into your bowel (via the bile) so that they can be eliminated from the body with your stool. Unfortunately, these toxins are able to be reabsorbed from the bowel and therefore cannot be eliminated (they continue to re-circulate to the liver and then back to the blood).
Dr. Shoemaker believes that one common situation where this occurs is in Lyme's disease. The Lyme infection has often already been eliminated by using Antibiotics but the toxins continues to persist in the body. Therefore people continue to be ill. He also believes that many other infections, including fungal infections that can be found in sick building syndromes and many waterborne infections can also produce similar toxins. It is possible that in the case of certain viral infections or after some traumatic injuries, the body's own genes may even be able to be tricked into continually making the toxins.
In addition to getting rid of the neurotoxins, it is important to support the body in two other key ways. These were developed and popularized by Dr. Russel Jaffe Ph.D. and are called the Vitamin C flush and the "Alkaline Way Diet". How to do these will be discussed below after we’ve discussed how to clear the neurotoxins.
So how can I test for these toxins?
Although there are no blood tests currently available, Dr. Shoemaker feels that your nervous system is very sensitive to these toxins. The retina in the back of the eye is part of the nervous system. He uses a test that examines the body's ability to discern different shades of black and gray. This VCS vision test (called the FACT) can be done on his web site (www.ChronicNeurotoxins.com -see this site for more info) for ~ $9. If you see a halo/glare around lights at night (which may cause trouble with driving), light sensitivity during the day, or have shooting pains, these symptoms (along with most of the other symptoms of CFS/fibromyalgia) are also suggestive of possible neurotoxins.
What is the treatment?
Because the liver is able to pull the toxins out of the body and excrete them into your bowel, the trick is to keep the toxins in your bowel so that they go out in the stool. Fortunately, there is an old medication called Questran (cholestyramine). It is a powder that acts like a sponge, and it used to be prescribed to pull cholesterol out of people's bodies. Dr. Shoemaker recommends that people take one scoop or one packet four times a day (although not as effective, you can sometimes get by with 3 times a day, however). Within a month (usually within 3 days to 2 weeks), those who are going to improve with this treatment will often start feeling better or at least have their vision test improve. Insomnia, pain and spastic colon symptoms can sometimes improve in 1-3 days with this treatment! If the Questran does not help symptoms or the vision test after 6 weeks, I have people stop the treatment. Most people are better and can stop cholestyramine after one month, but it can take 2 months for Lyme’s patients and those who have been ill with continuing toxin contact for a long time. When you improve and feel well with no further improvement in the symptoms or vision tests for 2 weeks in a row, suggesting that all of the toxin has been removed from your body, you can stop treatment. If symptoms recur, it suggests that something (e.g.- persistent infection or being in a “sick building”) is still making neurotoxins. This then should be treated as well. In this situation, I would continue the medication until it is no longer needed (e.g. -- try stopping it or lowering the dose every month). The main problem with Questran is that it soaks up everything. This means that you will likely not absorb a lot of the medications or supplements you are taking if they are taken at the same time as the Questran. Because of this, take the Questran/cholestyramine exactly this way: .
1- Take your thyroid as soon as you wake (leave it at your bedside with a glass of water). A half-hour later take your Daily Energy Enfusion vitamin powder, lipoic acid 300 mg and nystatin (and Cortef if prescribed). You can also take any other medications that are needed for other problems at this time. Take the Questran one hour later (1 scoop mixed in eight ounces of apple juice or distilled water followed by 12 ounces of distilled water). Exactly one-half hour after taking Questran, eat something that has at least a teaspoon of healthy fat (e.g. -- one egg or a pat of butter). Eating makes your body pour the neurotoxin containing bile into your gut. Eating ˝ hour after the Questran puts the medicine right where it needs to be (like a catchers mitt) to soak up and bind the neurotoxins.
2- Also take the next 2 doses of Questran (each day) as close to a half hour before lunch and dinner as you can. Take your last (4th) daily dose one-half hour before bedtime and eat some turkey or an egg right at bedtime. Take your sleep medications/herbals an hour before the nighttime Questran.
3- Drink 12 ounces of water after taking the Questran. It is best if the water is pure without any minerals. Distilled water is inexpensive and would be a good choice.
Constipation is normally a problem while on the Questran, so drink a lot of water and use prunes or other laxatives as needed to have at least 1 BM a day for the time you are on it. Dr, Shoemaker uses 70% sorbitol, 1-3 tsp three times a day as needed for constipation (available by mail from Cape Apothecary@ 410-757-3522). Using a laxative called “ Cleanse More” from “www.RenewLife.com”, prunes, or other laxatives may be gentler (see treatment protocol for constipation treatments). You should have at least 1-2 bowel movements every day while on the Questran. You need to keep things moving to get the toxin out of your body!
It is not uncommon for people to have their symptoms worsen -- sometimes dramatically -- when one first kills off a chronic infection. This is called a Herxheimer reaction and was first noted in the early days of treating syphilis. Since then, it has been seen in many infections, including fungal infections. Interestingly, some people also experience this when they begin Questran to remove the toxins. In speaking with Dr. Shoemaker, he recommends that those who flare with the Questran be tested and treated for Lyme disease and that they take a medication called Actos 45 mg a day for 7 days before restarting the Questran (and continue it for 3 days after resuming Questran) to decrease the die off reaction. While you're taking the Actos, you should also be on a diet that is very low in sugars (a “low amylose diet"). For this diet you should also avoid any root vegetables such as potatoes, carrots, etc. and you should also avoid all grains during that ten-day period as well. Because people with CFS/fibromyalgia tend to be very sensitive to medications anyway, you may choose to begin with one teaspoon of Questran once or twice daily for 1-2 days and then increase the dose as able to decrease the risk of getting a severe die off reaction. Although the infection/toxin die-off reaction is uncomfortable, it is a good sign that things are being cleared out and is worth going through. If you get the die-off, fill and take the Actos as discussed above for a week before resuming the Questran and let us know so we can look for Lyme’s and treat it. Fortunately, most people who do not have chronic Lyme’s syndrome improve without an infection/toxin die-off reaction. Although the Questran has ~ 1 tsp of Sugar per scoop, it is still OK to use in this situation. Using unsweetened cranberry juice (add stevia) instead of apple juice, or simply mixing it with water if even minimal Sugar is a problem will decrease the amount of Sugar you’re getting as well. You can also get Questran lite with NutraSweet.